The patient, who had an ischemic stroke (due to reduced blood flow to the brain as a result of narrowed or blocked arteries), needed to have her neck opened up for treatment. There are two main causes for this type of blockage: one is trauma, which is more common in young people. The second is through risk factors such as diabetes, high blood pressure, high cholesterol, and heart disease. However, the doctors could not find a history of any of these risk factors in the patient, nor could they find an association to trauma.

But the doctors, led by Dr. Manoj Mittal, noticed the woman´s right eyelid was droopy and her right pupil was slightly smaller than the left. When asked if this was abnormal for her, neither her nor her husband were sure. These conditions are typical symptoms of artery injury, and the doctors needed to be sure.

Mittal said he wanted to try to establish whether the eye problem was new or old, which would help the team in figuring out what the main cause was. He asked for the patient´s driver´s license, but it was old and tattered, and he couldn´t see her eyes. When asked if she had any other photos with her, or on her phone, she was quick to alert that she had none, except for those on Facebook.

She showed Mittal several pictures from her profile, which gave him recent examples of what she looked like. Through the pictures, he was able to discern that her eyes were more symmetric in the photos taken over the past few months, than they were after the stroke.

Based on the photographic Facebook information, it appeared the doctors had a patient on their hands that had stroke due to trauma. Yet, the patient remained adamant that she had not experienced any trauma.

Mittal had asked if she had visited a chiropractor lately, as there is some association between chiropractic manipulation and stroke, although no definitive link has been confirmed. She said she had gone to a chiropractor recently because of neck stiffness, and had spinal manipulation to treat it, just two days before the stroke.

Mittal said they had already treated the patient for stroke before they discovered her Facebook photos, but noted it is important to know the cause for the purposes of preventing another stroke.

“If we did not know that she had any trauma or anything, it´s very hard to explain why she had a stroke,” Mittal said. “Once you why the stroke happened, it´s more comfort for the patient.”

Mittal noted that early intervention helped in a good outcome for the patient, and she was discharged five days later. He added that when she first came to the ICU, she had slurred speech, droopiness in her face and complete paralysis of the left side of the face. But after treatment, her paralysis had gone away, although some symptoms remained.

Mittal said the timing of treatment is critical during a stroke. She got IV medication within two hours of the onset of her stroke, and intervention was done relatively quickly. The quicker a patient can get to the hospital, the quicker doctors can get to a blocked blood vessel to prevent further damage.